A nurse is caring for a client who experienced a lacerated spleen and has been on bedrest for several days. The nurse auscultates decreased breath sounds in the lower lobes of both lungs. The nurse should realize that this finding is most likely an indication of which of the following conditions?

A. "If you don't do your share of the work, I will have to inform the nurse manager"
This statement uses a threatening tone and may escalate the conflict. It does not promote open communication or collaboration to resolve the issue. Additionally, threatening to inform the nurse manager immediately can create a hostile work environment.
B. "Several staff members have commented that you don't do your fair share of the work."
While it's important to address concerns, singling out the staff nurse in front of others may cause embarrassment and defensiveness. It's better to address the issue privately to avoid further conflict and maintain professionalism.
C. "I need to talk to you about unit expectations regarding delegating and completing tasks."
This statement acknowledges the need for a discussion about unit expectations regarding delegating and completing tasks. By expressing the intention to have a conversation, it opens the door for dialogue and collaboration between the charge nurse and the staff nurse. This approach promotes a supportive and constructive environment for resolving conflicts and addressing concerns.
D. "You have been very inconsiderate of others by not completing your share of the work."
This statement is accusatory and confrontational, which can lead to defensiveness and resistance from the staff nurse. It does not facilitate effective communication or problem-solving. Constructive dialogue is essential for addressing conflicts and finding mutually beneficial solutions.

A. While heparin and warfarin both work as anticoagulants, IV heparin is not typically used to increase the effects of warfarin or decrease the length of hospital stay. Heparin is often administered initially to rapidly achieve therapeutic anticoagulation while waiting for warfarin to reach its full therapeutic effect, but it is not intended to directly enhance the action of warfarin.
B. This statement is accurate and provides a clear explanation to the client. Warfarin, an oral anticoagulant, takes several days to achieve a therapeutic level in the bloodstream and to exert its anticoagulant effect. During this time, IV heparin is continued to prevent clot formation until the therapeutic level of warfarin is reached.
C. While both heparin and warfarin work to prevent blood clots, they do not directly dissolve existing clots. Rather, they prevent the formation of new clots and the growth of existing ones. This explanation does not fully address the client's question regarding why both medications are necessary.
D. Discontinuing IV heparin prematurely without reaching a therapeutic level of warfarin could increase the risk of thrombus formation or embolization. Therefore, discontinuing IV heparin should be done under the guidance of the provider based on the client's INR levels and the target therapeutic range for warfarin.